Too Scared to Teach? The Unintended Impact of 360-Degree Feedback on Resident Education

In 2000, the Accreditation Council for Graduate Medical Education created a 360-degree feedback toolkit intended to provide residents with frequent feedback from both their peers and attending supervisors to address any deficiencies prior to graduation. At our institution, resident evaluations of faculty directly impact faculty pay and promotion. We aimed to evaluate attending physician's attitudes toward 360-degree feedback systems, specifically related to resident performance.

Attending radiologists in a single-institution radiology residency program answered a 10-question survey regarding their views on 360-degree feedback systems. Fisher's exact tests were used to compare proportions.

Seventeen of 24 (71%) attending physicians completed the survey. Of the respondents, 71% indicated that resident evaluations of attendings had an impact on job promotion and/or salaries; 65% indicated an impact on teaching quality; and 41% indicated an impact on their job security. All (100%) attendings indicated they felt comfortable giving positive written resident feedback, while 65% felt comfortable giving negative written feedback (P = 0.018). All (100%) attendings indicated they were comfortable giving positive verbal resident feedback, while 71% were comfortable giving negative verbal feedback (P = 0.044).

Attendings were less comfortable giving negative written and verbal resident feedback than positive feedback. Most attendings believed that negative resident evaluations of attendings had an impact on their pay and promotion. Attendings may be more willing to provide honest feedback to residents in a 360-degree system that does not link resident evaluations to faculty pay and promotion.